A novel technique for the safe transfer of the pedicle of a free flap in head and neck reconstruction using a nasopharyngeal airway connected to a negative pressure suction

Microsurgical free flaps are the accepted standard of care for head and neck reconstruction after tumor resection. In many cases, the pedicle of the free flap needs to be tunneled under bone and/or soft tissues to reach the recipient vessels in the site of anastomosis, most often located in the neck. Passing the pedicle through the dissected tunnel is always a blind procedure that increases the risk of shearing, turning, twisting, or kinking and in the worst case disconnection. We hereby demonstrate a novel and simple technique for a safe delivery of the pedicle to the anastomosis site in the neck using a nasopharyngeal airway (nasal airway) connected to negative pressure suction. In all of our cases, no complications were noted during the pedicle delivery to the neck while using this method. Level of Evidence: Level IV, therapeutic study.